| NPI | 1689371981 |
|---|---|
| Former Legal Business Name | BLACK COUCH THERAPY |
| Entity Type | Organization |
| Authorized Contact | TESIA S HEARD CEO 757-272-6330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-02-08 |
| Last Update Date | 2024-01-09 |